title: Defining optimal self-management in osteoarthritis: racial differences in a population-based sample.
abstract: The aim of this study was to examine optimal self-management in osteoarthritis and its association with patient-reported outcomes. We recruited a population-based sample of Medicare beneficiaries (n = 551) residing in Allegheny County, PA, USA and elicited an expanded set of self-management behaviors using open-ended inquiry. We defined optimal self-management according to clinical recommendations, including use of hot compresses on affected joints, alteration of activity, and exercise. Only 20% practiced optimal self-management as defined by two or more of these criteria. Optimal and suboptimal self-managers did not differ in sociodemographic features. Both white and African-Americans who practiced optimal self-management reported significantly less pain, but the benefit was greatest in severe disease for whites and for mild-moderate disease among African-Americans. This backdrop of naturally occurring self-management behaviors may be important to recognize in planning programs that seek to bolster self-management skills.
authors.affiliation: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, A211 Crabtree, 130 DeSoto St., Pittsburgh, PA 15261, USA. smalbert@pitt.edu
authors.forename: Steven M
authors.initials: SM
authors.lastname: Albert
authors.forename: Donald
authors.initials: D
authors.lastname: Musa
authors.forename: Kent
authors.initials: K
authors.lastname: Kwoh
authors.forename: Myrna
authors.initials: M
authors.lastname: Silverman
mesh_terms: D000368:Aged; D044383:Black People; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010003:Osteoarthritis / Q000208:ethnology / Q000628:therapy*; D010414:Pennsylvania; D012648:Self Care / Q000592:standards*; D044465:White People; D001741:Black or African American